Women with ADHD - Harsh Realities of a Daily Secret Battle

By Abigail de Munnik-Geerards, certified ADHD coach

Today is International Women’s Day, a day to celebrate women and their achievements around the globe and now more than ever this is needed in the neurodivergent field. Why? 

Let’s start with letting ADHD women tell their experience of having ADHD.

• “My nickname as a kid was Super-Klutz. My parents would sit on the front porch, see me limping down the street, maybe crying, and say, ‘Here comes Super-Klutz!’ I know they were trying to cheer me up from being hurt, but it did not have that effect.” — Amy, Illinois

• “Every report card I ever got talked about unrealized potential. And apparently I was ‘moody’ and a ‘day dreamer.’ It all hurt so much.” — Cathy

• “Flaky. Forgetful. Late. Messy. Disorganized. Comments like ‘you just need to __.’ Like it’s so simple. It distills into shame and trauma. Every time it is brought up again, it pokes at that pain.” — Ann

• "A friend told me: You’re so messy, it makes me feel better about myself when I see your place." — Abi

• "Everyone has ADHD nowadays, it’s just an excuse for being lazy and not doing the household." — Reaction on a post about burnout in ADHD women.

• “Being a mother with ADHD and having children with ADHD is even harder because the world expects you to parent like neither of you have it.” — Sofie

• “We are CONSTANTLY burnt out because we refuse to treat ourselves like we have a disability — because everyone needs something from us and wants it with a smile.” —  Courtney

• “Whatever someone is judging me about, I’m judging myself 49,367,473 x worse. It can be crushing.” — Olivia

• “I'm trying. All. The. Time. I'm. Trying.” — Lilah

So why highlight women with ADHD? Isn’t it difficult for everyone?

True ADHD is a disability in both men and women; however, research seems to indicate a whole range of difficulties ADHD women face, which men do not, or not as severe.

Internalisation

Women with ADHD often find themselves internalising their struggles, which can lead to feelings of self-blame. This painful pattern can contribute to anxiety, depression, and even complex trauma. For many years, the challenges faced by women with ADHD were dismissed as less severe. However, important research from Scandinavia has shed light on the disturbing reality that women with untreated ADHD are at greater risk for attempting suicide and may require psychiatric hospitalisation more often than men. It’s essential to recognise that the experience of ADHD in women can result in complex trauma. This occurs from a buildup of daily criticisms, rejections, and the weight of blame, which together create an overwhelming and ongoing trauma response—often described as "trauma by a thousand cuts." Rather than being a milder form of ADHD, the realities of this condition for women come with significant psychiatric risks throughout their lives. It’s crucial to understand and address these challenges with compassion and support.

Struggles to get diagnosed

One reason ADHD symptoms can manifest differently in women compared to men is due to the way society perceives and reacts to these behaviours. In boys and men, hyperactive and impulsive symptoms tend to be more external, leading to disruptions in the classroom and at home. This often prompts parents and educators to recognise the symptoms more quickly. In contrast, girls may internalise their hyperactivity or mask their symptoms. Instead of expressing energy through disruptive behaviour, they might feel pressured to be nurturing and supportive, often moving around the class room helping classmates, it's still signs of hyperactivity, but it is not considered unwanted behaviour. It’s also important to note that certain behaviours typically associated with women, such as being chatty, can actually be signs of hyperactivity. Sadly, these traits are often seen as just part of being a girl, so they frequently go unrecognised as potential symptoms of ADHD. This discrepancy in understanding is rooted mainly in a history where ADHD research has primarily concentrated on males, resulting in a significant gap in knowledge about how this condition affects women. Unfortunately, this means that ADHD research focused specifically on women still has a long way to go. Diagnostic criteria, like those in the DSM-V, have been shaped primarily by the male experience of ADHD, making it even more challenging for women to receive an accurate diagnosis. 

Societies expectations

Today, many women find themselves facing an overwhelming array of demands that can feel almost impossible to manage. Women are juggling their work responsibilities while simultaneously raising children, keeping track of family schedules, organising events, and maintaining their households. Even as society’s perspectives on gender roles have evolved, the expectations placed on wives and mothers still tend to be far more demanding than those of husbands and fathers. A recent article in Forbes Magazine emphasises that although women have been earning college degrees at higher rates than men over the past two decades, and nearly half now serve as their family’s primary breadwinners, they still bear an unequal burden. Women are 8 times more likely to take on the responsibility of caring for a sick child and managing their children’s schedules, which can add to the feeling of being stretched thin. Currently, 75% of mothers with school-aged children are employed, demonstrating a significant shift in the societal landscape. However, this change hasn’t been matched by increased affordable and accessible childcare options, which can create substantial stress for working mothers. Imagine how challenging it must be for a woman with ADHD to navigate these expectations. It’s understandable that “overwhelmed” often becomes the defining word to describe the experiences of women with ADHD. The traditional roles that society expects wives to fill can be particularly difficult for women who struggle with ADHD, making it vital for us to recognise and empathise with the unique challenges they face in balancing their many responsibilities.

Hormones

At its core, ADHD is an issue with dopamine production and neurotransmission, and in both these processes, estrogen and progesterone play an important factor. Not only does the level of these hormones go up and down in a woman's natural cycle, but also during her life, there are many significant points where these hormones play a role. This means during a regular cycle, ADHD symptoms will get better and worse depending on where a woman is in her cycle. And then on top of that, puberty, pregnancy and birth, peri-menopause and menopause all affect ADHD symptoms. Recent research has shown that 28.7% of the general population struggle with PMDD (Premenstrual Dysphoric Disorder), whereas this increases to 45.5% in the ADHD population. The lowering of estrogen means our brain's natural dopamine production is lowered, but also, our ADHD medication is dependent on estrogen, so our medication has less effect. This creates a perfect storm of increased ADHD symptoms and increased emotional and psychological distress, which can start up to 2 weeks before the start of our period and magically disappear about 2-3 days after our period starts. The research is very new, but the lived experience is not, and it has a deep impact on ADHD women.

Conclusion

The sad truth is ADHD women are more likely to attempt suicide than men, and that’s on top of the fact that ADHDers, in general, are 5x more likely to attempt suicide than the general population. Thankfully, because of increased research, more and more help is available, but we still have a long way to go. That is why it is important today to celebrate women who are proudly ADHD, who open up the conversation around what it is like to have ADHD and the struggles we face and to break down the stigmatism around neurodevelopmental differences. To celebrate all of us ADHD women who fight to make this world a little more sparkly every day.

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